Whincup P, Cook D, Papacosta O, Walker M, Perry I
Department of Public Health and Primary Care, Royal Free Hospital School of Medicine, London, UK.
J Hum Hypertens. 1994 May;8(5):337-43.
It has been suggested that risks of hypertension and cardiovascular disease begin in utero and that maternal nutrition plays an important role. We have examined the relation between maternal factors and BP in a study of 1,311 children in which physical measurements at 9-11 years of age have been linked to a parental questionnaire; birth record data were also available in a subsample of 662 children. Maternal height was inversely related to childhood BP after adjustment for the child's current height. However, several social factors related to maternal nutrition in pregnancy in earlier studies (including social class, housing tenure, maternal educational attainment and maternal smoking in pregnancy) showed weak and inconsistent relations with BP at 9-11 years. Minimum maternal haemoglobin in pregnancy and change in mean corpuscular volume in pregnancy (identified as potentially important markers of maternal nutrition in earlier studies) showed no consistent relationships either with placental weight to birthweight ratio or with childhood BP, although both factors showed strong inverse associations with birthweight. The association between maternal height and childhood BP may reflect the influence of early life factors on cardiovascular risk. However, the absence of consistent relationships between social factors and BP in offspring provides little support for the possibility that maternal diet is an important influence on cardiovascular risk factors in childhood. Minimum maternal haemoglobin and change in maternal mean corpuscular volume are unlikely to be specific markers of maternal nutrition in pregnancy. More specific hypotheses relating maternal nutrition to the development of cardiovascular risk in offspring are required.
有人提出，高血压和心血管疾病的风险始于子宫内，且母亲的营养起着重要作用。在一项对1311名儿童的研究中，我们考察了母亲因素与血压之间的关系，该研究将9至11岁儿童的体格测量结果与一份家长问卷相关联；在662名儿童的子样本中也可获取出生记录数据。在对孩子当前身高进行校正后，母亲身高与儿童血压呈负相关。然而，在早期研究中与孕期母亲营养相关的几个社会因素（包括社会阶层、住房保有情况、母亲教育程度以及孕期母亲吸烟）与9至11岁儿童的血压关系微弱且不一致。孕期母亲血红蛋白最低值以及孕期平均红细胞体积变化（在早期研究中被确定为母亲营养的潜在重要指标）与胎盘重量与出生体重之比或儿童血压均无一致关系，尽管这两个因素与出生体重均呈强负相关。母亲身高与儿童血压之间的关联可能反映了早期生活因素对心血管风险的影响。然而，社会因素与后代血压之间缺乏一致关系，这几乎无法支持母亲饮食对儿童心血管风险因素有重要影响这一可能性。孕期母亲血红蛋白最低值和母亲平均红细胞体积变化不太可能是孕期母亲营养的特异性指标。需要提出更具体的关于母亲营养与后代心血管风险发展之间关系的假设。
